﻿<!DOCTYPE html>
<html lang="en">
<#include "../common/common-head.html"/>
<body class="gray-bg top-navigation">
<div id="wrapper">
    <div id="page-wrapper" class="gray-bg">
    <#include "../common/common-menu.html">
        <div class="wrapper wrapper-content">
            <div class="row white-bg" style="padding: 18px 0">
                <div class="col-xs-12">

                    <form class="form-horizontal m-t"
                          action="${basePath}/admin/userapply/save" method="post"
                          enctype="multipart/form-data">
                    <#if userapply?? >
                        <input type="hidden" name="agent" value="${userapply.mt4account!}">
                    </#if>
                        <div class="col-xs-6">
                            <div class="form-group">
                                <label class="col-xs-3 control-label">货币：</label>
                                <div class="col-xs-8">
                                    <input class="form-control" name="huobi" value="USD" type="text"
                                           required>
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label">账户类型：</label>
                                <div class="col-xs-8">
                                    <select class="form-control" name="zhanghuleixing">
                                        <option value="标准型账户（固定)">标准型账户（固定）
                                        </option>
                                        <option value="标准型账户（浮动）">标准型账户（浮动）
                                        </option>
                                        <option value="机构型账户">
                                            机构型账户
                                        </option>
                                    </select>
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">预计初始存款：</label>
                                <div class="col-xs-8">
                                    <input required class="form-control" name="deposit"
                                           type="text">
                                </div>
                            </div>


                            <div class="form-group">
                                <label class="col-xs-3 control-label">客户类型：</label>
                                <div class="col-xs-8">
                                    <select class="form-control" name="client">
                                        <option value="individual">
                                            个人
                                        </option>
                                        <option value="joint">联合</option>
                                        <option value="corporate">公司
                                        </option>
                                    </select>
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">居住城市：</label>
                                <div class="col-xs-8">
                                    <input name="city" required class="form-control">
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">国籍：</label>
                                <div class="col-xs-8">
                                    <input name="nationlity" required class="form-control">
                                </div>
                            </div>


                            <div class="form-group">
                                <label class="col-xs-3 control-label">性别：</label>
                                <div class="col-xs-8">
                                    <select class="form-control" name="sex">
                                        <option value="male">男</option>
                                        <option value="female">女</option>
                                    </select>
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">姓名：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="username"
                                           class="form-control">
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">证件号：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="idcard"
                                           class="form-control">
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">身份证正面：</label>
                                <input required name="img" type="file" >
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">身份证反面：</label>
                                <input required name="img" type="file" >
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">银行卡正面：</label>
                                <input required name="img" type="file" >
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">银行卡反面：</label>
                                <input required name="img" type="file" >
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">出生日期：</label>
                                <div class="col-xs-3">
                                    <input type="text" required name="year"
                                           class="form-control">
                                </div>
                                <div class="col-xs-2">
                                    <input type="text" required name="month"
                                           class="form-control">
                                </div>
                                <div class="col-xs-2">
                                    <input type="text" required name="day"
                                           class="form-control">
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">婚姻状况：</label>
                                <div class="col-xs-4">
                                    <select class="form-control" name="marital">
                                        <option value="未结婚">未结婚</option>
                                        <option value="已结婚">已结婚</option>
                                    </select>
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label"> 电子邮件：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="email"
                                           class="form-control">
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">手机号码：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="phone"
                                           class="form-control">
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">传真：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="fax"
                                           class="form-control">
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">住宅地址：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="address"
                                           class="form-control">
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label">邮寄地址：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="postaddress"
                                           class="form-control">
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label">省市：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="province"
                                           class="form-control">
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label">邮编：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="postcode"
                                           class="form-control">
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">工作状况：</label>
                                <div class="col-xs-8">
                                    <select class="form-control" name="employment">
                                        <option value="职员">职员</option>
                                        <option value="个体工商业主">
                                            个体工商业主
                                        </option>
                                        <option value="私企业主">私企业主
                                        </option>
                                        <option value="其他">其他</option>
                                    </select>
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label">公司名称：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="companyname"
                                           class="form-control">
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label">公司地址：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="companyaddress"
                                           class="form-control">
                                </div>
                            </div>

                        </div>
                        <div class="col-xs-6">
                            <div class="form-group">
                                <label class="col-xs-3 control-label">业务性质：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="naturebusiness"
                                           class="form-control">
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label">职位：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="position"
                                           class="form-control">
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label">政府部门官员职位：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="relationsNote"
                                           class="form-control">
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">收入来源：</label>
                                <div class="col-xs-8">
                                    <select class="form-control" name="income">
                                        <option value="工资">工资</option>
                                        <option value="投资分红">投资分红</option>
                                        <option value="其他">其他</option>
                                    </select>
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">年收入或盈利（美元）：</label>
                                <div class="col-xs-8">
                                    <select class="form-control" name="profit">
                                        <option value="10万以下">10万以下
                                        </option>
                                        <option value="10-50万">10-50万
                                        </option>
                                        <option value="50-100万">50-100万
                                        </option>
                                        <option value="100万以上">100万以上
                                        </option>
                                    </select>
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">净资产（美元）：</label>
                                <div class="col-xs-8">
                                    <select class="form-control" name="assets">
                                        <option value="10万以下">10万以下
                                        </option>
                                        <option value="10-50万">10-50万
                                        </option>
                                        <option value="50-100万">50-100万
                                        </option>
                                        <option value="100万以上">100万以上
                                        </option>
                                    </select>
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">了解交易杠杆衍生性商品所涉及的风险：</label>
                                <div class="col-xs-8">
                                    <select class="form-control" name="risk">
                                        <option value="是">是</option>
                                        <option value="否">否</option>
                                    </select>
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">银行名称：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="bankname"
                                           class="form-control">
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">所属支行：</label>
                                <div class="col-xs-2">
                                    <input type="text" required name="bankaddress"
                                           class="form-control">
                                </div>
                                <div class="col-xs-3">
                                    <input type="text" required name="bankaddress2"
                                           class="form-control">
                                </div>
                                <div class="col-xs-3">
                                    <input type="text" required name="bankaddress3"
                                           class="form-control">
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">账户持有人姓名：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="accountholder"
                                           class="form-control">
                                </div>
                            </div>

                            <div class="form-group">
                                <label class="col-xs-3 control-label">国际汇款代码：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="swift"
                                           class="form-control">
                                </div>
                            </div>


                            <div class="form-group">
                                <label class="col-xs-3 control-label">银行账号：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="accountcode"
                                           class="form-control">
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label">Forex：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="forxselect"
                                           class="form-control">
                                </div>
                            </div>


                            <div class="form-group">
                                <label class="col-xs-3 control-label">CFDs：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="cfdsselect"
                                           class="form-control">
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label">大宗商品：</label>
                                <div class="col-xs-8">
                                    <input type="text" required
                                           name="commoditiesselect"
                                           class="form-control">
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label">期货/期权：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="futuresselect"
                                           class="form-control">
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label">债券/股票：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="shareselect"
                                           class="form-control">
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label"> 通过渠道：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="hearus"
                                           class="form-control">
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label">模拟账户：</label>
                                <div class="col-xs-8">
                                    <input type="text" required name="demotext"
                                           class="form-control">
                                </div>
                            </div>
                            <div class="form-group">
                                <label class="col-xs-3 control-label">用户类型：</label>
                                <div class="col-xs-8">
                                    <input type="radio" checked name="usertype" value="user">普通用户
                                    <input type="radio" name="usertype" value="agent">代理用户
                                </div>
                            </div>
                            <div class="form-group">
                                <div class="col-xs-8 col-xs-offset-3">
                                    <button class="btn btn-primary" type="submit">提交</button>
                                </div>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div>
</div>
</body>
</html>

